A Property/DOH Discussion Guide

Planning and partnering with your local department of health

Contents
About this Guide......
Background Information......
What is a Closed POD?......
Why Become a Closed POD?......
Is this Program Tested?......
Does my property want to become a Closed POD?
Entering a Relationship with the DOH
Benefits of Working with a Hotel Property
Working with the DOH......
Initial Contact......
Agreement, Process, and the Draft Dispensing Plan
Closed POD Plan......
Practice the Plan......
Closed POD Planning Detail and Discussion Guide
Notification and Activation......
Medication Delivery and Transport.....
Medication Handling and Management..
Dispensing Decisions......
Staffing......
Communications......

Closed POD Planning Detail and Discussion Guide

About this Guide

This guide is intended to help you both prepare and work through your Closed POD (point of dispensing) Plan—first on your own and then in partnership with your local department of health (DOH). It provides background information to help youfirst decide whether it’s in your organization’s best interest to become a Closed POD.

Next, this guide will help you think through what to consider when entering a partnership with the DOH. It will provide an outlined process to work in collaboration with the DOH.

Finally, this guiderevealscriticalplanning elements and offers discussion questions to use in collaboration with both your property’s Command Team and the DOH, toconstruct the approved Closed POD Plan for your property.

Background Information

In preparation for a potential public health emergency that would involve an aerosolized release of anthrax, the Federal government requires that every DOH dispense lifesaving medications toits jurisdiction’s entire population. Some DOH’s may consider their dispensing plan complete and ready to implement. Others may believe that their current plan does not reach the entire population. Therefore, they may be looking for supplemental options to complete their plan. Using Closed PODs offers the DOH a wider range of options for reaching more people in the event of an emergency.

What is a Closed POD?

A Closed POD is a non-medical dispensing site employed during a public health emergency thatprovides potentially lifesaving medication to a pre-determined population. The goal of the POD is to avert illness by rapidly distributing preventative medication to large numbers of people during an emergency.

Why Become a Closed POD?

The hospitality industry has a strong culture of corporate responsibility and safety. By operating a Closed POD, a hotel can rapidly provide lifesaving medication to its associates and their families, registered guests and special function guests, and in-house vendor/contractors and their families. By treating this targeted population during a public health emergency, your hotel helps reduce the burden on “Open or public PODs” (dispensing locations set up for the general public) and associates can return to duty quickly after receiving their medication.

The hospitality industry is uniquely positioned to act in this public service role because hotels and their associates are already trained to serve large populations efficiently, calmly, and courteously. Additionally, the service infrastructure is in place and can be “re-tooled” to provide effective service during a public health emergency.

Is this Program Tested?

The Closed POD Planning Kit was developed as part of a pilot project involving 8jurisdictions and 44 properties. The project was tested and evaluated in multiple phases and in multiple locations. Each pilot location went through the process of developing an operational Closed POD Plan with their local department of health (DOH) and has subsequently tested that plan in partnership with their local DOH.

Does my property want to become a Closed POD?

Begin by reviewing the contents of the Closed POD Planning Kit. The kit contains all of the materials you need to plan and operate your Closed POD operations. Also, consider the following to help you determine whether it makes sense for your property to become a Closed POD.

Considerations

Your Corporate and/or the hotel owner’s recommendation, thoughts, and commitment to support your property in the Closed POD planning process.

Your property’s ability to commit and apply resources to the program. Becoming a Closed POD requires dedicated planning and practice time as well as committed resources.

Your ability to work well with your local DOH. A successful Closed POD requires a collaborative and functional relationship. Your local DOH will assist your property in making key planning decisions and will guide your property though practice exercises and drills.

Entering a Relationship with the DOH

If you have decided it makes sense for your property to become a Closed POD, before you contact the local DOH, consider why you believe yourproperty makes an excellent Closed POD and public health partner. The benefits below will aid your initial conversation with the DOH.

Benefits of Working with a HotelProperty

Why do hotels make good Closed PODs?

Hotels are well equipped and well positioned to set up Closed PODs. Many properties have large meeting rooms or ballrooms in which they regularly conduct large-scale events. Staff is trained to efficiently set up, orchestrate, and breakdown these rooms for events, so that in house set-up and execution skills are guaranteed. These skills are crucial to operating a Closed POD. Also, properties have available facilities to temporarily store medications and the means to transport that medication safely from one location to the next.

Why do Hotel properties make great partners?

Hotel staff is highly trained in functions akin to the Closed POD job roles, such as Greeters and Screeners. Initial program tests and feedback have indicated that hotelvolunteers have adapted to Closed POD roles expertly while delivering excellent customer service beyond the expectation of evaluators.Furthermore, properties have established procedures and experience handling disgruntled guests. Therefore, hotel properties have the skilled staff to deal with potentiallyill or unruly recipients.

Will a Closed POD serve enough people to make it worthwhile?

Hotels offer the best opportunity to reach the unaccounted population (travelers) that a public health department would have a difficult time reaching in the event of an emergency. Hotels are able to provide a vital service to people who would have no idea where local Open PODs are located and would likely not have the transportation to get there.

Closed POD Property/DOH Discussion Guide • Page 1

Closed POD Planning Detail and Discussion Guide

Working with the DOH

The following tablesguide you through the main phasesfor initiating a relationship and working with your local DOH t0plan your Closed POD operations in partnership with them.

Initial Contact

What You Do / What You Need / Outcome / Questions for Discussion
Make initial contact with the [Director of] your local DOH to determine if they are equipped to partner with your property to plan your Closed POD operation. /

Know which health department has jurisdiction over your location. It may be a city or county entity.

Gain information about your local DOH’s mandate. Capture their requirements for mass prophylaxis (dispensing medication to a large population).
Determine if the DOH has a need to work with Closed PODs and is interested in working with your property.
Offer to send Closed POD Planning Kit documents to your contact to preview. Suggested documents are the MOA Template, Dispensing Plan Template, and Primary Coordinator’s Job Action Sheet.
Set a date for the next phone call or decide notto move forward.

Who is the appropriate person at the DOH to enter into agreement with your hotel to become Closed POD?
We’ve received a lot of information about Closed PODsand are just beginning to work with aDraft Dispensing Plan. Are you working with Closed PODs?
If so, is this something we can work together on? Are you interested in collaborating with our hotel on a Closed POD Plan?

Agreement, Process, and the Draft Dispensing Plan

What You Do / What You Need / Outcome / Questions for Discussion
A
Initiate a follow up phone conversation to discuss the Planning Kit documents. Determine who will be key decision-makers/planners, and get agreement to move forward. /

Familiarity with the Planning Kit documents.
Know your property has the commitment, resources, and support to operate a Closed POD.
Know that it is reasonable to opt out if DOH requirements place an undue burden on your organization.

Know the primary decision-maker.
Know the primary contact(s) for planning.
Understand the DOH’s Closed POD approval process.
Establish the relationship.
Verbal agreement to work together to operate a Closed POD.

Are the documents I sent you anything like those you are currently using?
Do you have any concerns about working with us as a Closed POD partner?
Do you have a Memorandum of Agreement (MOA) template already established for Closed PODs or do you like the one I sent you?
Does the MOA need to be signed before we go to the next step? Who else does it make sense to involve at this stage?
Do you have a Closed POD Plan templateyou would like us to use or can we use the one I sent you?
How will we work through theDispensing Plan together? Who else needs to be involved?

B
Work with your hotel management and the DOH to draft the Memorandum of Agreement (MOA). /

Memorandum of Agreement Template document (Microsoft Word format) found in your Closed POD Planning Kit.
Instructionsdocument found in your Closed POD Planning Kit.

Solid draft of the MOA, with input and agreement from hotel management and DOH decision-makers.

C
Work with your hotel management and Command Team to draft your Closed POD Plan. Submit the Draft Dispensing Plan to the DOH. /

Closed POD Planning Guide Template document (Microsoft Word format).
Instructionsdocument found in your Closed POD Planning Kit.

Submitted draft plan to share and discuss with the DOH.

Closed POD Plan

What You Do / What You Need / Outcome / Questions for Discussion
A
Schedule a site visit for your DOH partners to visit your property. Use the Site Visit Discussion Worksheet to walk through all selected locations and review the viability and logistics of dispensing location(s) and methods you’ve chosen to use. /

Draft Dispensing Plan
Maps and floor plans of your property

Adjustments to the Draft Dispensing Plan as necessary
Documentation of decisions/agreements

/ To work through this phase, use the Closed POD Planning Detail and Discussion Guide beginning on page 6.
B
Make modifications to theDispensing Plan based on the results of the site visit. Have subsequent discussions with the DOH as necessary. /

In-process Draft Dispensing Plan

Adjustments to the Draft Dispensing Plan as necessary
Documentation of decisions/agreements

C
Finalize your Closed POD Plan. Once finalized, you’ll send a copy of your Approved Dispensing Plan to the DOH to keep on file. /

In-process DraftDispensing Plan

Approved Closed POD Plan
Signed MOA
Plan for periodic updating of the Closed POD Plan

Practice the Plan

What You Do / What You Need / Outcome / Notes
Conduct tabletop and functional exercises to test Closed POD Plan effectiveness. /

A schedule to conduct tabletop and functional exercises both on your own and with the DOH
Exercises found in the Closed POD Planning Kit

Post-drill results documentation on file with your property and the DOH
Adjustments to theApproved Closed POD Plan as needed

Closed POD PlanningDetail and Discussion Guide

Use the information below and the Closed POD Plan Template to craft your property’s Draft Dispensing Plan. Use the discussion questions in collaboration with your local DOH to arrive at your property’sApproved Closed POD Plan.

Notification and Activation

/ Questions for Discussion

In these two crucial phases of the Closed POD Plan, know who from the DOH will send the Notification and Activation messages to your property and by what modality those messages will arrive.

Who is the appropriate person at the DOH to notify your propertyand activate the Closed POD?
What communication method will you use to notify and activate the Closed POD, e.g. phone, email, text, etc. (Be sure to address both the initial and the redundant communication.)
What number should the Primary Coordinator call if they have not been contacted within four hours of the initial declaration of a public health emergency?
If DOH phone lines are down and the property cannot confirm an alert, what is the alternate plan?

Medication Delivery and Transport

►Pick up or Delivery / Questions for Discussion

Determine if the DOH will deliver medications or if you will pickup and transport them to your property. Use the discussion questions to work through the medication delivery and transport process and details.

Will DOH incorporate your locations into current distribution strategy or require your hotel to pick up medication?
How large of a vehicle is needed to pick up the medication?

►Transfer of Possession / Questions for Discussion

Associates picking up or accepting medications from DOH on the day of an event may require authorization to take possession.

What documentation and identification are required for your hotel to take possession of the medication?
What details need to be worked through so that this property is able to accept medication delivery with ease?
Can the delivery truck enter the property’s dock space?
Are doors wide enough to accept a stacked pallet?
Will the property need to break a pallet to transfer it?
Are service elevators available?
Is the necessary equipment available at the property to move boxes of medication?
What delivery pattern needs to be established to keep medication delivery separate from the flow of traffic and people at the property?
How close is the dock to the temporary medication storage and dispensing areas?
Can the DOH provide a sample of the Medical Material Transfer form?

Medication Handling and Management

/ Questions for Discussion

Decide with the DOH which medication or combination of medication will be available for your property to distribute. Use the questions at right to determine the best temporary storage location for medication and a process for inventory management.

Medication will arrive on a pallet of approximately what size?
Boxes of medication will be what approximate size?
Given the size restrictions, where is the best place or places to temporarily store the medication before transporting it to a dispensing area?
What templates has DOH developed to assist the property with tracking inventory?
Are there inventory management forms available?
Is there a process to request additional inventory?
Who do we contact to request additional medication? What is the phone number?

Dispensing Decisions

►Dispensing Strategy / Process Steps

Work with the medication dispensing variables and constraints to plot your property’s ideal dispensing strategy. Work in collaboration with the DOH to adjust your strategy as needed to arrive at the ideal throughput.
Use the outlined process at right to guide your site visit and determine the ideal dispensing set-up and layout for your property. Note that your local DOH may have a software program that will help you calculate the ideal layout and identify the number of dispensing stations needed to obtain the idealthroughput.

Estimate the property’s targeted dispensing population (see Dispensing Population, page 10) and number of Volunteers.

Distinguish the dispensing method (e.g. ballroom dispensing) or combination of methods (e.g. ballroom and associate pick-up) [see Dispensing Method Pros and Cons, page11].
Determine constraints—either physical space or number of Volunteers (see Staffing Volunteers, page 13).
Determine the throughput rate based on dispensing population, dispensing method(s), design layout, and number of available Volunteers.
Adjust layout design, dispensing method combination, and/or number of Volunteers if dispensing time is excessive.

►Ballroom Dispensing Layout Design / Questions for Discussion
Decide how to best layout your ballroom space for optimal throughput. /

How do people get in and out of the dispensing area so that the flow moves in one direction only?
How is medication transported throughout the hotel (from the dock to storage, from storage to staging, from staging to the dispensing area) so it doesn’t cross paths with guests or waiting recipients?
If we use the Associate or Manager Pick-up methods, how do we send people to the alternate dispensing area without forming large groups?
What kind of separation is necessary between guests and associates?

► Space Allocation / Questions for Discussion
If your property has multiple ballrooms or large rooms, work with the DOH to configure space optimally so that space is designed for optimal flow and crowd control. /

Is the use of air walls appropriate?
How will the queue flow?
How will we ensure crowd control?

►Dispensing Population / Questions for Discussion

Note that “head of household” in the Dispensing Plan Template defines “household” loosely. For example, the head of household policy is designed so that one person may list live-in family members, elderly neighbors, or parents on their Medication Screening Form. This policy reduces the number of people waiting in the queue for medications.
Each DOH jurisdiction uses an average to calculate estimates for family households. Use this number in the Targeted Dispensing Population Calculation Table in the Dispensing Plan Template, to determine your property’s maximum dispensing capacity.

What number does your local DOH use to represent the average household?

► Dispensing Methods / Pros and Cons

There are four potential methods to dispense medications to your facility’s dispensing population. All properties will use the Ballroom Dispensing method. Decide what other methods or combination of methods work best for your property. The table at right lists some of the pros and cons of each dispensing method.

/ Dispensing Method / Pros / Cons
Ballroom Dispensing
One large location is set up to serve the entire dispensing population (or a portion if used in conjunction with other methods) /

Efficient dispensing for the entire dispensing population

Associates are in the same queue as guests and others potentially requiring a longer wait before returning to work

Room Service Dispensing
Medication is delivered to guest rooms /

Guests receive medication in the comfort and privacy of their rooms
Less movement of people throughout the property

Can take longer than ballroom dispensing
Requires additional Volunteers
Requires additional space in either storage area or staging area

ManagerPick-up
Managers pick up medications from a designated location and distribute it to associates /

Associates do not have to leave their job stations to receive medication
Hotel operations can continue without disruption

Requires involvement of all managers, taking time away from their other duties
Requires additional space in either storage area or staging area
May require additional action if there are questions for the associate about information on the Medication Screening Form

AssociatePick-up
Associates pick up medications from a designated location /

Can be done in shifts so few associates are away from their stations at any one time

Need to have associate area large enough and configured correctly to accommodate flow

► Dispensing Policies and Guidelines / Questions for Discussion

Discuss and determine what prevailing policies will guide Closed POD dispensing.

What is the maximum number of medication bottles that an associate can pick up?
What is the maximum number of medication bottles that a guest can pick up?
How does the property handle unaccompanied minors?
What ID, if any, is required to receive medication?
Security during dispensing—use of force guidelines
What training is required to dispense medications, if any?
What kind of liability protection is necessary?
What standard procedure will we use for ill or disorderly guests?
What is the procedure for recipients with disabilities?

Staffing